Cell and Organ Transplantology. 2023; 11(2):114-121.
DOI: 10.22494/cot.v11i2.157
Mesenchymal stem cell therapy modulates macrophage dynamics in ARDS-associated liver injury in rats
Redko O.
, Dovgalyuk A.
, Kramar S.
, Ohinska N.
, Nebesna Z.
, Korda M.![]()
- I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Abstract
Acute respiratory distress syndrome (ARDS) is a life-threatening pulmonary condition characterized by severe hypoxemia and respiratory failure. Beyond its devastating impact on the lungs, ARDS often triggers systemic responses affecting vital organs throughout the body. One such organ commonly affected is the liver, which experiences various degrees of injury during the course of ARDS. Pathophysiological changes in liver during ARDS, particularly polarization of Kupffer cells during the disease and its treatment, have drawn increasing attention.
Purpose. To explore the macrophage transformation in liver injury associated with ARDS and investigate the potential of multipotent mesenchymal stromal/stem cell (MMSCs) therapy as a means to modulate macrophage responses and mitigate liver injury.
Methods. 72 mature male Wistar rats were randomly allocated to nine experimental groups as follows: the control group, groups assessed at 3 days, 7 days, and 28 days following intranasal lipopolysaccharide (LPS) administration, groups that received 24 hours of LPS followed by 2 days of human umbilical cord-derived multipotent mesenchymal stromal cells (hUC-MMSCs), groups exposed to 4 days of LPS and 3 days of hUC-MMSCs, groups subjected to 14 days of LPS and 14 days of hUC-MMSCs, groups treated with LPS 21 days and 7 days with hUC-MMSCs injection, and a control group assessed 3 days after hUC-MMSCs injection. For the administration of hUC-MMSCs, intraperitoneal injections were performed at a dose of 1×106 cells/kg body weight. Immunohistochemistry was used to analyze macrophage subpopulations in liver tissue for CD68 as a pan-macrophage marker, CD86 for the identification of M1 macrophages, CD163 – for the identification of M2 macrophages.
Results. Early ARDS stages showed increased M1 macrophages, indicating pro-inflammatory responses, while later stages showed M2 macrophage activation, suggestive of anti-inflammatory properties and tissue repair roles. hUC-MMSCs administration facilitated the transition from M1 to M2 macrophages, promoting an anti-inflammatory milieu.
Conclusion. hUC-MMSCs demonstrate the potential to modulate macrophage polarization into M2 anti-inflammatory phenotype. Such findings reflect one of the mechanisms of MMSCs action which holds practical significance for future ARDS therapies, aiming to mitigate excessive inflammation and enhance tissue repair.
Key words: aacute respiratory distress syndrome; liver injury; multipotent mesenchymal stromal cells; macrophage polarization; inflammation, immunomodulation
Full Text PDF
| 1. Shyamala V, Harini R, Manikandan D, Riyaz SM. Acute Respiratory Distress Syndrome (ARDS). In: An Epidemiological Update on COVID-19. 2022; 1. https://doi.org/10.2174/9789815050325122010005 |
||||
| 2. Huppert LA, Matthay MA, Ware LB. Pathogenesis of acute respiratory distress syndrome. Semin Respir Crit Care Med. 2019; 40(1):31-39. https://doi.org/10.1055/s-0039-1683996 PMid:31060086 PMCid:PMC7060969 |
||||
| 3. Michael AM, Zemans RL, Zimmerman GA, et al. Acute respiratory distress syndrome. Nat Rev Dis Primers. 2019; 5:18. https://doi.org/10.1038/s41572-019-0069-0 PMid:30872586 PMCid:PMC6709677 |
||||
| 4. Herrero R, Sánchez G, Asensio I, López E, Ferruelo A, Vaquero J, et al. Liver-lung interactions in acute respiratory distress syndrome. Intensive Care Med Exp. 2020; 8(1):1-13. https://doi.org/10.1186/s40635-020-00337-9 PMid:33336286 PMCid:PMC7746785 |
||||
| 5. Kallet RH, Lipnick MS, Zhuo H, Pangilinan LP, Gomez A. Characteristics of nonpulmonary organ dysfunction at onset of ARDS based on the Berlin definition. 2019. https://doi.org/10.4187/respcare.06165 PMid:30992403 |
||||
| 6. Guillot A, Tacke F. Liver macrophages: old dogmas and new insights. Hepatol Commun. 2019; 3(6):730-743. https://doi.org/10.1002/hep4.1356 PMid:31168508 PMCid:PMC6545867 |
||||
| 7. Dawood RM, Salum GM, Abd El-Meguid M. The impact of COVID-19 on liver injury. AJMS. 2022, 363(2):94-103. https://doi.org/10.1016/j.amjms.2021.11.001 PMid:34752738 PMCid:PMC8571104 |
||||
| 8. Harnisch LO, Baumann S, Mihaylov D, Kiehntopf M, Bauer M, Moerer O, et al. Biomarkers of cholestasis and liver injury in the early phase of acute respiratory distress syndrome and their pathophysiological value. Diagnostics. 2021; 11(12):2356. https://doi.org/10.3390/diagnostics11122356 PMid:34943592 PMCid:PMC8699895 |
||||
| 9. Gando S, Fujishima S, Saitoh D, Shiraishi A, Yamakawa K, Kushimoto S, et al. The significance of disseminated intravascular coagulation on multiple organ dysfunction during the early stage of acute respiratory distress syndrome. Thromb Res. 2020; 191:15-21. https://doi.org/10.1016/j.thromres.2020.03.023 PMid:32353745 |
||||
| 10. Livingstone SA, Wildi KS, Dalton HJ, Usman A, Ki KK, Passmore MR, et al. Coagulation dysfunction in acute respiratory distress syndrome and its potential impact in inflammatory subphenotypes. Front Med. 2021; 8:723217. https://doi.org/10.3389/fmed.2021.723217 PMid:34490308 PMCid:PMC8417599 |
||||
| 11. Chang, JC. Acute respiratory distress syndrome as an organ phenotype of vascular microthrombotic disease: based on hemostatic theory and endothelial molecular pathogenesis. CATH. 2019; 25:1076029619887437. https://doi.org/10.1177/1076029619887437 PMid:31775524 PMCid:PMC7019416 |
||||
| 12. Wang CH, Chen CY, Wang KH, Kao AP, Chen YJ, Lin PH, et al. Comparing the Therapeutic Mechanism and Immune Response of Human and Mouse Mesenchymal Stem Cells in Immunocompetent Mice With Acute Liver Failure. Stem Cells Transl Med. 2023. https://doi.org/10.1093/stcltm/szac084 PMid:36610716 PMCid:PMC9887270 |
||||
| 13. Zhang Y, Li Y, Li W, Cai J, Yue M, Jiang L, et al. Therapeutic effect of human umbilical cord mesenchymal stem cells at various passages on acute liver failure in rats. Stem Cells Int. 2018. https://doi.org/10.1155/2018/7159465 PMid:30538751 PMCid:PMC6261392 |
||||
| 14. Shi D, Xin J, Lu Y, Ding W, Jiang J, Zhou Q, et al. Transcriptome profiling reveals distinct phenotype of human bone marrow mesenchymal stem cell-derived hepatocyte-like cells. Int J Med Sci. 2020; 17:263-73. https://doi.org/10.7150/ijms.36255 PMid:32038110 PMCid:PMC6990879 |
||||
| 15. Coronado RE, Somaraki-CormierM, Ong JL, Halff GA. Hepatocyte-like cells derived from human amniotic epithelial, bone marrow, and adipose stromal cells display enhanced functionality when cultured on decellularized liver substrate. Stem Cell Res. 2019; 38:101471. https://doi.org/10.1016/j.scr.2019.101471 PMid:31163390 |
||||
| 16. Wang Z, Li W, Guo Q, Wang Y, Ma L, Zhang X. Insulin-like growth factor-1 signaling in lung development and inflammatory lung diseases. BioMed Res Int. 2018. https://doi.org/10.1155/2018/6057589 PMid:30018981 PMCid:PMC6029485 |
||||
| 17. Yang Y, Zhao Y, Zhang L, Zhang F, Li L. The application of mesenchymal stem cells in the treatment of liver diseases: mechanism, efficacy, and safety issues. Front Med. 2021. https://doi.org/10.3389/fmed.2021.655268 PMid:34136500 PMCid:PMC8200416 |
||||
| 18. Zhang S, Yang Y, Fan L, Zhang F, Li L. The clinical application of mesenchymal stem cells in liver disease: the current situation and potential future. Ann Transl Med. 2020; 8:565. https://doi.org/10.21037/atm.2020.03.218 PMid:32775366 PMCid:PMC7347776 |
||||
| 19. Xie Q, Liu R, Jiang J, Peng J, Yang C, Zhang W, et al. What is the impact of human umbilical cord mesenchymal stem cell transplantation on clinical treatment? Stem Cell Res Ther. 2020; 11:519. https://doi.org/10.1186/s13287-020-02011-z PMid:33261658 PMCid:PMC7705855 |
||||
| 20. Fiore EJ, Dominguez LM, Bayo J, Garcia MG, Mazzolini GD. Taking advantage of the potential of mesenchymal stromal cells in liver regeneration. Cells and extracellular vesicles as therapeutic strategies. World J Gastroenterol. 2018; 24:2427-40. https://doi.org/10.3748/wjg.v24.i23.2427 PMid:29930465 PMCid:PMC6010941 |
||||
| 21. Feng J, Yao W, Zhang Y, Xiang AP, Yuan D, Hei Z. Intravenous anesthetics enhance the ability of human bone marrow-derived mesenchymal stem cells to alleviate hepatic ischemia-reperfusion injury in a receptor-dependent manner. Cell Physiol Biochem. 2018; 47:556-66. https://doi.org/10.1159/000489989 PMid:29794450 |
||||
| 22. Higashi T, Friedman SL, Hoshida Y. Hepatic stellate cells as key target in liver fibrosis. Adv Drug Deliv Rev. 2017; 121:27-42. https://doi.org/10.1016/j.addr.2017.05.007 PMid:28506744 PMCid:PMC5682243 |
||||
| 23. Tacke F. Targeting hepatic macrophages to treat liver diseases. J Hepatol. 2017; 66:1300-12. https://doi.org/10.1016/j.jhep.2017.02.026 PMid:28267621 |
||||
| 24. Sato K, Hall C, Glaser S, Francis H, Meng F, Alpini G. Pathogenesis of Kupffer cells in cholestatic liver injury. Am J Pathol. 2016; 186:2238-47. https://doi.org/10.1016/j.ajpath.2016.06.003 PMid:27452297 PMCid:PMC5012503 |
||||
| 25. Hu C, Zhao L, Zhang L, Bao Q, Li L. Mesenchymal stem cell-based cell-free strategies: safe and effective treatments for liver injury. Stem Cell Res Ther. 2020; 11:377. https://doi.org/10.1186/s13287-020-01895-1 PMid:32883343 PMCid:PMC7469278 |
||||
| 26. Rong XL, Liu JZ, Yao X, Jiang TC, Wang YM, Xie F. Human bone marrow mesenchymal stem cells-derived exosomes alleviate liver fibrosis through the Wnt/beta-catenin pathway. Stem Cell Res Ther. 2019; 10:98. https://doi.org/10.1186/s13287-019-1204-2 PMid:30885249 PMCid:PMC6421647 |
||||
| 27. Ohara M, Ohnishi S, Hosono H, Yamamoto K, Yuyama K, Nakamura H, et al. Extracellular vesicles from amnion-derived mesenchymal stem cells ameliorate hepatic inflammation and fibrosis in rats. Stem Cells Int. 2018; 2018:3212643. https://doi.org/10.1155/2018/3212643 PMid:30675167 PMCid:PMC6323530 |
||||
| 28. Redko O, Dovgalyuk A, Nebesna Z, Kramar S, Sverstyuk A, Korda M. Human umbilical cord-derived мesenchymal stromal cells mitigate lipopolysaccharide-induced liver injury in rats. Cell Organ Transpl. 2023; 11(1):34-45. https://doi.org/10.22494/cot.v11i1.148 |
||||
| 29. Huang X, Xiu H, Zhang S, Zhang G. The role of macrophages in the pathogenesis of ALI/ARDS. Mediators Inflamm. 2018. https://doi.org/10.1155/2018/1264913 PMid:29950923 PMCid:PMC5989173 |
||||
| 30. Lee JW, Chun W, Lee HJ, Min JH, Kim SM, Seo JY, et al. The Role of Macrophages in the Development of Acute and Chronic Inflammatory Lung Diseases. Cells. 2021; 10: 897. https://doi.org/10.3390/cells10040897 PMid:33919784 PMCid:PMC8070705 |
||||
| 31. Dang W, Tao Y, Xu X, Zhao H, Zou L. Li Y. The role of lung macrophages in acute respiratory distress syndrome. Inflamm Res. 2022; 71(1)2:1417-1432. https://doi.org/10.1007/s00011-022-01645-4 PMid:36264361 PMCid:PMC9582389 |
||||
| 32. Chen X, Tang J, Shuai W, Meng J, Feng J, Han Z. Macrophage polarization and its role in the pathogenesis of acute lung injury/acute respiratory distress syndrome. Inflammation Research. 2020; 69:883-895. https://doi.org/10.1007/s00011-020-01378-2 PMid:32647933 PMCid:PMC7347666 |
||||
| 33. Liu C, Xiao K, Xie L. Advances in the regulation of macrophage polarization by mesenchymal stem cells and implications for ALI/ARDS treatment. Front Immunol. 2022, 13:928134. https://doi.org/10.3389/fimmu.2022.928134 PMid:35880175 PMCid:PMC9307903 |
||||
| 34. Tao H, Xu Y, Zhang S. The role of macrophages and alveolar epithelial cells in the development of ARDS. Inflammation. 2023; 46(1):47-55. https://doi.org/10.1007/s10753-022-01726-w PMid:36048270 PMCid:PMC9435414 |
||||
| 35. Arora S, Dev K, Agarwal B, Das P, Syed MA. Macrophages: Their role, activation and polarization in pulmonary diseases. Immunobiology. 2018; 223:383-396. https://doi.org/10.1016/j.imbio.2017.11.001 PMid:29146235 PMCid:PMC7114886 |
||||
| 36. Zhang C, Yang M, Ericsson AC. Function of macrophages in disease: current understanding on molecular mechanisms. Front Immunol. 2021; 12:620510. https://doi.org/10.3389/fimmu.2021.620510 PMid:33763066 PMCid:PMC7982479 |
||||
| 37. Domscheit H, Hegeman MA, Carvalho N, Spieth PM. Molecular dynamics of lipopolysaccharide-induced lung injury in rodents. Front Physiol. 2020; 11:36. https://doi.org/10.3389/fphys.2020.00036 PMid:32116752 PMCid:PMC7012903 |
||||
| 38. George T, Chakraborty M, Giembycz MA, Newton R. A bronchoprotective role for Rgs2 in a murine model of lipopolysaccharide-induced airways inflammation. Allergy Asthma Clin Immunol. 2018; 14(1):1-14. https://doi.org/10.1186/s13223-018-0266-5 PMid:30305828 PMCid:PMC6166284 |
||||
| 39. de Souza Xavier Costa N, Ribeiro Júnior G, dos Santos Alemany AA, Belotti L, Zati DH, Frota Cavalcante M, et al. Early and late pulmonary effects of nebulized LPS in mice: An acute lung injury model. PLoS One. 2017; 12(9):e0185474. https://doi.org/10.1371/journal.pone.0185474 PMid:28953963 PMCid:PMC5617199 |
||||
| 40. Barnett-Vanes A, Sharrock A, Birrell MA, Rankin S. A single 9-colour flow cytometric method to characterise major leukocyte populations in the rat: validation in a model of LPS-induced pulmonary inflammation. PLoS One. 2016; 11(1):e0142520. https://doi.org/10.1371/journal.pone.0142520 PMid:26764486 PMCid:PMC4713146 |
||||
| 41. Alvites R, Branquinho M, Sousa AC, Lopes B, Sousa P, Maurício AC. Mesenchymal Stem/Stromal Cells and Their Paracrine Activity-Immunomodulation Mechanisms and How to Influence the Therapeutic Potential. Pharmaceutics. 2022; 14(2):381. https://doi.org/10.3390/pharmaceutics14020381 PMid:35214113 PMCid:PMC8875256 |
||||
| 42. Fu X, Liu G, Halim A, Ju Y, Luo Q, Song AG. Mesenchymal Stem Cell Migration and Tissue Repair. Cells. 2019; 8(8):784. https://doi.org/10.3390/cells8080784 PMid:31357692 PMCid:PMC6721499 |
||||
| 43. Kwon JH, Kim M, Bae YK, Kim GH, Choi SJ, Oh W, et al. Decorin Secreted by Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells Induces Macrophage Polarization Via Cd44 to Repair Hyperoxic Lung Injury. Int J Mol Sci. 2019; 20(19):4815. https://doi.org/10.3390/ijms20194815 PMid:31569732 PMCid:PMC6801980 |
||||
| 44. van Niel G, D’Angelo G, Raposo G. Shedding Light on the Cell Biology of Extracellular Vesicles. Nat Rev Mol Cell Biol. 2018; 19(4):213-28. https://doi.org/10.1038/nrm.2017.125 PMid:29339798 |
||||
| 45. Mouton AJ, Li X, Hall ME, Hall JE. Obesity, Hypertension, and Cardiac Dysfunction: Novel Roles of Immunometabolism in Macrophage Activation and Inflammation. Circ Res. 2020; 126(6):789-806. https://doi.org/10.1161/CIRCRESAHA.119.312321 PMid:32163341 PMCid:PMC7255054 |
||||
| 46. Luque-Campos N, Bustamante-Barrientos FA, Pradenas C, García C, Araya MJ, Bohaud C, et al. The Macrophage Response Is Driven by Mesenchymal Stem Cell-Mediated Metabolic Reprogramming. Front Immunol. 2021; 12:624746. https://doi.org/10.3389/fimmu.2021.624746 PMid:34149687 PMCid:PMC8213396 |
||||
| 47. Deng H, Wu L, Liu M, Zhu L, Chen Y, Zhou H, et al. Bone Marrow Mesenchymal Stem Cell-Derived Exosomes Attenuate Lps-Induced Ards by Modulating Macrophage Polarization Through Inhibiting Glycolysis in Macrophages. Shock. 2020; 54(6):828-43. https://doi.org/10.1097/SHK.0000000000001549 PMid:32433208 |
||||
| 48. Laing AG, Riffo-Vasquez Y, Sharif-Paghaleh E, Lombardi G, Sharpe PT. Immune Modulation by Apoptotic Dental Pulp Stem Cells in Vivo. Immunotherapy. 2018; 10(3):201-11. https://doi.org/10.2217/imt-2017-0117 PMid:29370720 PMCid:PMC5810843 |
||||
| 49. Cheung TS, Galleu A, von Bonin M, Bornhäuser M, Dazzi F. Apoptotic Mesenchymal Stromal Cells Induce Prostaglandin E2 in Monocytes: Implications for the Monitoring of Mesenchymal Stromal Cell Activity. Haematologica. 2019; 104(10):e438-e41. https://doi.org/10.3324/haematol.2018.214767 PMid:30846505 PMCid:PMC6886441 |
||||
| 50. de Witte SFH, Luk F, Sierra Parraga JM, Gargesha M, Merino A, Korevaar SS, et al. Immunomodulation by Therapeutic Mesenchymal Stromal Cells (Msc) Is Triggered Through Phagocytosis of Msc by Monocytic Cells. Stem Cells. 2018; 36(4):602-15. https://doi.org/10.1002/stem.2779 PMid:29341339 |
||||
| 51. Pang SHM, D’Rozario J, Mendonca S, Bhuvan T, Payne NL, Zheng D, et al. Mesenchymal Stromal Cell Apoptosis Is Required for Their Therapeutic Function. Nat Commun. 2021; 12(1):6495. https://doi.org/10.1038/s41467-021-26834-3 PMid:34764248 PMCid:PMC8586224 |
||||
| 52. Dutra Silva J, Su Y, Calfee CS, Delucchi KL, Weiss D, McAuley DF, et al. Mesenchymal Stromal Cell Extracellular Vesicles Rescue Mitochondrial Dysfunction and Improve Barrier Integrity in Clinically Relevant Models of Ards. Eur Respir J. 2021; 58(1):2002978. https://doi.org/10.1183/13993003.02978-2020 PMid:33334945 PMCid:PMC8318599 |
||||
| 53. Morrison TJ, Jackson MV, Cunningham EK, Kissenpfennig A, McAuley DF, O’Kane CM, et al. Mesenchymal Stromal Cells Modulate Macrophages in Clinically Relevant Lung Injury Models by Extracellular Vesicle Mitochondrial Transfer. Am J Respir Crit Care Med. 2017; 196(10):1275-1286. https://doi.org/10.1164/rccm.201701-0170OC PMid:28598224 PMCid:PMC5694830 |
||||
| 54. Fiore E, Malvicini M, Bayo J, et al. Involvement of hepatic macrophages in the antifibrotic effect of IGF-I-overexpressing mesenchymal stromal cells. Stem Cell Res Ther. 2016; 172(7). https://doi.org/10.1186/s13287-016-0424-y PMid:27876093 PMCid:PMC5120504 |
||||
| 55. Yanwei Li, Qiuju Sheng, Chong Zhang, Chao Han, Hai Bai, Pingping Lai, et al. STAT6 up-regulation amplifies M2 macrophage anti-inflammatory capacity through mesenchymal stem cells. Int Immunopharmacol. 2021. https://doi.org/10.1016/j.intimp.2020.107266 PMid:33321466 |
||||
Redko O, Dovgalyuk A, Kramar S, Ohinska N, Nebesna Z, Korda M. Mesenchymal stem cell therapy modulates macrophage dynamics in ARDS-associated liver injury in rats. Cell Organ Transpl. 2023; 11(2):114-121. Available from: https://doi.org/10.22494/cot.v11i2.157

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

